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What is already known about this subject • In tube-fed patients with severe neurodevelopmental problems, omeprazole for the treatment of gastro-oesophageal reflux disease (GORD) often needs to be administered through the feeding tube. • In daily practice, various procedures are used to administer the commercially available, enteric-coated omeprazole-formulations through a feeding tube. • However, no bioavailability-data are available to support a rational choice between the available administration procedures. What this study adds • This study demonstrates a substantial interindividual variability in omeprazole pharmacokinetics after administration through the gastrostomy tube in patients with severe neurodevelopmental problems. • In most patients, plasma concentration time profiles seem more favourable with a suspension formulation than with a MUPS(®) formulation. • Consequently, there is no apparent advantage in choosing a MUPS(®) formulation over the more easily administered suspension formulation.
Aims: Omeprazole is often administered through a gastrostomy tube as either (1) a Multiple Unit Pellet System (MUPS(®) ) tablet disintegrated in water (MUPS(®) formulation), or (2) a suspension in 8.4 % sodium bicarbonate (suspension formulation). This bioavailability study evaluates this practice in tube-fed patients with severe neurodevelopmental problems. Methods: nonblinded, two-phase cross-over trial. Results: In 7/10 patients, bio-availability was higher for the suspension formulation than for the MUPS(®) formulation. Median (90% CI) area under the plasma concentration-time curve (AUC)-ratio (MUPS(®) over suspension) was 0.5 (0.06-2.37). Conclusions: In this population, omeprazole MUPS(®) formulation has no apparent advantage over the more easily administered suspension formulation.
Laboratory of Medical Biochemistry and Clinical Analysis, Ghent University, Harelbekestraat 72, 9000 Gent, Belgium Department of Pharmacy, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium Department of Paediatric Gastroenterology, Ghent Uni
This article was published in the following journal.
Name: British journal of clinical pharmacology
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The use of multiple drugs administered to the same patient, most commonly seen in elderly patients. It includes also the administration of excessive medication. Since in the United States most drugs are dispensed as single-agent formulations, polypharmacy, though using many drugs administered to the same patient, must be differentiated from DRUG COMBINATIONS, single preparations containing two or more drugs as a fixed dose, and from DRUG THERAPY, COMBINATION, two or more drugs administered separately for a combined effect. (From Segen, Dictionary of Modern Medicine, 1992)
Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes.
Food and dietary formulations including elemental (chemically defined formula) diets, synthetic and semisynthetic diets, space diets, weight-reduction formulas, tube-feeding diets, complete liquid diets, and supplemental liquid and solid diets.
A tube of ectodermal tissue in an embryo that will give rise to the CENTRAL NERVOUS SYSTEM, including the SPINAL CORD and the BRAIN. Lumen within the neural tube is called neural canal which gives rise to the central canal of the spinal cord and the ventricles of the brain. For malformation of the neural tube, see NEURAL TUBE DEFECTS.
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